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Antidepressants Are Overprescribed, Says Doctor

A doctor writing for the British Medial Journal (BMJ) has stated that antidepressants are overprescribed. His views are part of a debate on the BMJ website over treatment with antidepressants.

Dr. Des Spence, a general practitioner from Glasgow, said that “”we use antidepressants too easily, for too long, and that they are effective for few people (if at all).” Though he acknowledges that depression is real, he argued that the definition of clinical depression is too general and is “causing widespread medicalization.”

Spence also points out that antidepressant prescriptions in the U.K. rose to 46 million in 2011, a 9.6% increase. He questions the view that depression is a simply chemical imbalance, and believes antidepressants are becoming “a distraction from a wider debate about why we are so unhappy as a society.”

“But even if we accept that antidepressants are effective, a Cochrane review suggests that only one in seven people actually benefits,” said Spence. “Thus millions of people are enduring at least six months of ineffective treatment.”

On the other side of the debate, Ian Reid, a professor of Psychiatry at the University of Aberdeen, argues that the rise in antidepressant prescriptions is due to an increasing duration of treatment, rather than a rise in the number of people prescribed the medications.

Reid dismisses most of Spences claims, pointing to a survey of doctors that shows “cautious and conservative prescribing.” He also states that there are “methodological flaws” in studies showing that antidepressants are no better than placebos for mild depression.

“Antidepressants are but one element available in the treatment of depression, not a panacea,” said Reid. “Like ‘talking treatments’ (with which antidepressants are entirely compatible), they can have harmful side effects, and they certainly don’t help everyone with the disorder. But they are not overprescribed. Careless reportage has demonized them in the public eye, adding to the stigmatisation of mental illness, and erecting unnecessary barriers to effective care.”